AIDS Daily Summary
November 5, 1993
The Centers for Disease Control and Prevention (CDC) National AIDS
Clearinghouse makes available the following information as a public
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Copyright 1993, Information, Inc., Bethesda, MD
"AIDS Hysteria Grips Germany"
Washington Post (11/05/93) P. A32 (Atkinson, Rick)
In the face of a worsening contaminated blood scandal, tens of
thousands of Germans swamped hospitals, clinics, and health
agencies to inquire about HIV testing. "We can't answer all the
calls, there are just too many," said Christa
Mueller-Breitkreutz, head of the local health agency in Bonn.
"We can't get on with other work." The hysteria was set off by
the recommendations of Health Minister Horst Seehofer and other
health officials that any patient who received transfusions or
blood products since the early 1980s be tested for the AIDS
virus. Several other health officials criticized the
government's call for mass testing, calling it premature and an
overreaction. Frank Ulrich Montgomery, head of a prominent
organization of physicians, noted that "only about 10 percent of
surgical operations involve administering blood or blood
products." Others pointed out that certain products are treated
with heat or chemicals that kill most viruses. It is uncertain
exactly how many former patients will be tested. A large German
newspaper ran a headline announcing that 15 million people would
take the AIDS test, although officials predict that the actual
number will be much lower. Related Stories: New York Times
(11/05) P. A1; Financial Times (11/05) P.1
"4-Year Investigation Exonerates AIDS Researcher"
Washington Post (11/05/93) P. A12 (Brown, David)
Charges of "scientific misconduct" in the writing of a 1984 AIDS
paper were cleared against a former NIH scientist yesterday by
the Department of Health and Human Services. Mikulas Popovic had
been accused by the department's Office of Research Integrity
(ORI) of writing a paper that included "untrue statements," but
the four-year investigation failed to prove this, or that any
falsifications were intentional. Ultimately, the allegations
were stripped down to interpretations that ORI deemed knowingly
false, and others said were not more than hasty errors. "One
might anticipate that from all this evidence ... there would be
at least a residue of palpable wrongdoing," wrote the panel in a
79-page opinion. "That is not the case." Popovic's paper
reported the successful growth of the AIDS virus in cell culture,
a development that helped make an AIDS test possible. The
charges stemmed from entries on a table of data, an ambiguous
sentence, and a disagreement between Popovic and a lab
technician. While Popovic, 52, has been exonerated, NIH
researcher Robert C. Gallo, then Popovic's boss, is scheduled to
go before the same HHS appeals board Monday to defend himself
against misconduct charges involving AIDS papers. Gallo is
accused of misappropriating the AIDS virus from French
researchers. Related Story: New York Times (11/05) P. A28.
"Sex Ed at School, Home Is Key, AIDS Czar Says"
Philadelphia Inquirer (11/05/93) P. B1 (Collins, Huntly)
AIDS czar Kristine Gebbie yesterday called for more sex education
in schools and at home to help combat the national AIDS crisis.
"It's our failure to talk that has caused children to experiment
with their sexuality in ways that are dangerous to them,"
theorized Gebbie. While urging that children as young as 12 be
taught about condoms as a means of protection against AIDS,
Gebbie said the decision to make condoms available in schools
should be left to school authorities, not the federal government.
Gebbie's comments were delivered at the Franklin Institute in
Philadelphia, where an hour later she opened the museum's AIDS
exhibit. The interactive exhibit, which includes a video giving
explicit directions on how to put on a condom, was hailed by
Gebbie as "a new direction in AIDS education." The AIDS czar
also called for an expansion of research, more activist
involvement in setting research priorities, and more attention to
AIDS curricula in medical schools.
"Needle Scare at Time Magazine"
Washington Post (11/05/93) P. G1 (Romano, Lois)
Time magazine's Washington Bureau was thrown into a panic this
week when 19 staffers learned that some of the syringes used to
administer flu shots were used more than once. Several employees
noticed that internist Wesley Oler was giving shots, wiping off
the needle with cotton and alcohol, then moving on to the next
shot recipient. Although this is has been an unacceptable
medical practice for many years, staffers waited until the doctor
left to discuss the issue and present their concerns to
management. Bureau chief Dan Goodgame recommended HIV and
hepatitis tests, at the expense of the magazine, for the
inoculated staffers. John Cornwall, Time's medical director,
yesterday visited the Washington bureau, where he recommended
safe sex practices to the employees. Oler, a prominent
physician, acknowledged reusing syringes. "I ran short of
needles and used some of them twice after carefully scrubbing
them down with alcohol sponges," he explained. Pamela Howard, a
spokesperson for the Centers for Disease Control and Prevention,
said Oler's procedures were not in accordance with CDC
guidelines. "Sterilization is essential for hypodermic needles
because they do enter deep tissue," said Howard. "Use of liquid
germicides such as alcohol doesn't guarantee sterility." Time
has reported Oler to the District of Columbia department of
public health.
"D.C. Could Face TB Epidemic, Panel Warns"
Washington Post (11/05/93) P. B3 (:Loose, Cindy)
Unless the District of Columbia immediately improves testing and
treatment for tuberculosis, the city could suffer a full-blown
epidemic, cautioned a panel of physicians from the Centers for
Disease Control and Prevention and the American Lung Association.
"The District has all the ingredients for a TB epidemic," said
panel chairman Bill Banton, describing an increasing number of
patients who exacerbate the problem by failing to take medication
as prescribed, which results in the development of deadly
drug-resistant strains of the disease. TB is primarily affecting
D.C. residents who are HIV-positive, drug addicts, incarcerated,
or homeless. Although the study only looked at the capital, the
specialists also warned of suburban problems with the disease,
which has increased due to immigrants, who account for 70 percent
of reported infectious cases in Northern Virginia. The doctors
are calling for a state-of-the-art TB laboratory to replace the
old lab, which is not equipped to test whether a strain is
drug-resistant. They also recommended care beds for homeless TB
patients and called for community action.
"Wild Things"
Advocate (11/02/93) No. 641, P. 15
AIDS group administrators and government policy makers were
plagued in September by loose talk, sloppy management, and shady
pasts. In Puerto Rico, for instance, top health official Enrique
Vazquez Quintana was fired Sept. 14 after commenting during a
broadcast interview that a severe shortage of AZT at a San Juan
hospital "does not make any difference" because the AIDS patients
who need it "are going to die anyway." Although Vazquez Quintana
protested that his statement was taken out of context, Gov. Pedro
Rossello declined to reinstate him, choosing instead to name
Carmen Feliciano to the position as health secretary. According
to the Centers for Disease and Prevention, Puerto Rico has the
second-highest per capita rate of AIDS in the country. In
Galveston, Texas, David Petty was dismissed as executive director
of the AIDS Coalition of Coastal Texas following allegations that
he made unauthorized payroll advances to himself and
misappropriated $2,000 from the group for the personal purchase
of a pickup truck. Petty denied the accusations, but on Sept.
17, was charged with felony. A Sept. 20 article in the Detroit
Free Press alleging that only 4 percent of the $450,000 collected
by the National Alliance for Children With AIDS actually went to
services for infected children forced the organization to
disband. Finally, in San Francisco, nonprofit AIDS group Cal-PEP
replaced its board president after allegations of his criminal
activity placed $161,500 in jeopardy. J
"Center Helps People Get the Answers on AIDS"
Washington Blade (10/29/93) Vol. 24, No. 46, P. 10 (Clark,
Darice)
For many people, an HIV-positive diagnosis is the beginning of a
long educational process. In Washington, D.C., one place where
HIV-infected individuals can get information is the AIDS Resource
Center, located in a thrift shop in Northwest. Just opened
months ago, the center is a community-based, non-clinical center
where people to make phone calls to get answers to their AIDS
questions. It is also a "safe space" for people who have tested
positive for the virus, but have not yet disclosed their
condition to family, friends, or colleagues. Founders Steve
Michaels and Wayne Turner hope that the center will eventually be
a work area for AIDS activists as well. "The idea is to empower
people," says Michaels. "Sharing information is important if you
want to effect change and find a cure." Michaels and Turner want
the center to be linked to all major computer networks across the
nation with access to AIDS information. The thrift shop, which
houses clothing and furniture donations mostly from people who
have died from AIDS, funds the AIDS Resource Center and pays the
rent. Although this was not the location the founders originally
anticipated, they admit now that the storefront makes the center
more accessible and visible.
"News in Brief: Europe Against AIDS"
Lancet (10/09/93) Vol. 342, No. 8876, P. 922
The European Commission has asked the EC governments for a
one-year extension of the 1991-93 "Europe Against AIDS" program.
Primarily created to help fund projects in member states, the
program has, to date, supported some 80 projects. For the
upcoming year, the Commission plans to focus on projects
involving AIDS and drug abuse, HIV transmission within the prison
system, HIV transmission associated with travel and tourism, the
increasing numbers of women and children who are infected, and
fighting discrimination against people with the disease.
"FDA Panel: Revoke DDC-AZT OK, Back Monotherapy"
American Medical News (10/25/93) Vol. 36, No. 40, P. 10 (Staver,
Sari)
The FDA's anti-viral drugs advisory panel has strongly
recommended that the agency rescind its tentative approval of the
anti-HIV drug DDC to be used in conjunction with AZT. Group
members back DDC as a single agent. Last year, DDC became the
first drug under a program that allows experimental products to
hit the market before final studies are finished. Since then,
the use of the combination has increased steadily in patients
whose CD4 lymphocyte levels fall after AZT therapy. Those on the
committee made the first recommendation because a new study found
combination therapy equals monotreatment in effectiveness,
according to Dr. Alvin Novic, a biology professor at Yale
University. Clinicians on the panel claimed that this limitation
would not obstruct access to DDC. Insurance policies usually
don't reimburse for "off-label" applications, but in practice
insurers rarely watch prescribing habits. Dr. Kenneth Mayer, who
directs the HIV program at Brown University School of Medicine,
requested "more compelling evidence" that combination therapy is
ineffective. He supports keeping DDC as part of AZT therapy.
"Alloimmunization as an AIDS Vaccine?"
Science (10/08/93) Vol. 262, No. 5131, P. 161 (Shearer, Gene M.
et al.)
The speculations of Stott and colleagues, and the work of Larry
Arthur et al. suggest the idea of a vaccine for HIV based on
cellular proteins known as human lymphocyte antigens (HLAs).
These proteins can be identified as HLA alloantigens when first
entering the host during the first stages of HIV infection.
Studies indicate that protection of macaques against SIV (the
equivalent of the AIDS virus in monkeys) is correlated with the
presence of antibodies against HLA antigens. Recognition of HLA
alloantigens supports the theory of Plummer et al. that
prostitutes in Nairobi who seemed to be resistant to HIV may have
used alloantigen recognition to reject HIV-infected leukocytes in
semen before efficient HIV infection could occur. Shearer et al.
note advantages of alloimmunization as a potential HIV vaccine.
Allogeneic response is the strongest known antigen-specific
immune response, does not require preimmunization, and is well
developed at birth. It is also responsible for foreign tissue
allograft rejection, which could kill allogeneic leukocytes
introduced by parenteral exposure. On the down side,
alloantigen-immunized people may not be good candidates for
allografts. Also, it is impossible to determine which HLA
antigens would need to be known. Finally, immunization with
foreign leukocytes comes with the risk of infecting the
individual with other viruses.
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